Horizon Blue Cross Blue Shield Coverage for Inpatient Rehab Centers in New Jersey
Addiction is a serious disease that is extremely difficult to overcome. One of the biggest components and fears of those who are ready to seek treatment is whether they can afford it.
If you have an insurance plan, such as Horizon BCBS, you may be able to receive treatment for addiction, including at inpatient alcohol and drug rehab centers, at little to no cost to you. Whether treatment is covered and how much is covered depends on the plan you have, where you live, and the treatment center you select.
Verify whether your insurance covers drug and alcohol rehab by calling the number on the back of your insurance card to speak to a Horizon BCBS representative. You can also reach out to an American Addiction Centers (AAC) by phone or chat for help or call an AAC-accredited rehab facility to check whether your plan would be accepted.
What is Horizon BCBS NJ?
Horizon BCBS NJ is a part of the larger nationwide Blue Cross Blue Shield insurance network. Horizon BCBS NJ has been providing health insurance products and services to families and businesses throughout the state of New Jersey since 1932.1 Serving 21 counties in New Jersey and providing coverage to nearly 3.5 million people, BCBS NJ is the seventh-largest BCBS plan in the country.2
There are many rehab centers in New Jersey and the tri-state area that are considered in-network treatment facilities under BCBS NJ health plans. Many AAC-accredited facilities are considered in-network providers under BCBS NJ plans, so you may be able to have your rehab fully or partially covered through your insurance plan.
Click here to find a facility near you.
How Much Does Horizon BCBS Cover (Addiction Treatment) in NJ?
How much of your addiction treatment Horizon BCBS covers will depend on the plan you select and the treatment center you attend. Although the breadth of coverage will vary, as will your recommended course of treatment, many plans will cover the following common treatment methods:3
- Horizon BCBS NJ For Inpatient/residential treatment is arguably the most well-known form of addiction treatment. It typically involves staying in a facility for a few days or weeks (inpatient care) or months (residential care), while you receive around-the-clock care. Care often includes detox and withdrawal support, medication, therapy, and other medical care.
- Horizon BCBS NJ For Standard outpatient treatment is another well-known form of addiction treatment. With outpatient care, you typically go to a facility once or twice a week and receive therapy or other types of care. Then, you return home to manage your condition on your own.
Inpatient and outpatient treatment methods aren’t the only options, though. In some cases, your recommended course of treatment may involve elements of both inpatient and outpatient care. These treatment methods may include:3
- Horizon BCBS NJ For Partial hospitalization programs (PHPs) are when you attend a few hours of treatment programs during the day every day, but you’re allowed to go home after your treatments are done. You typically will receive care multiple days a week.
- Horizon BCBS NJ For Intensive outpatient programs (IOP) are when you receive therapy or other similar outpatient treatments a couple of days a week, but then you return home. It’s typically more structured than standard outpatient treatment, but not as involved as inpatient or PHPs.
Again, it’s important to keep in mind that your specific situation and provider will determine what type of treatment is the best fit for you. Whether your insurance plan will cover treatments fully or partially will depend upon your individual circumstances and care provider.
Does Horizon BCBS Insurance Cover Mental Health Care in NJ?
Under the federal healthcare reform act, the Affordable Care Act (ACA), every health plan—including your BCBS plan—must cover essential health benefits in some capacity. Of the 10 essential health benefits that must be covered, mental and behavioral health services are included.4 This means that your BCBS plan must provide some level of coverage for such services, including treatment for substance use disorders, inpatient care for mental and behavioral health disorders, and behavioral health treatment.4
If you’re struggling with both a mental health and substance use disorder, that is known as a co-occurring disorder. Thanks to the ACA’s mandate, you can get the care that you need, as treating both disorders is essential for your long-term successful recovery.
How Long Does Horizon BCBS Insurance Cover Inpatient Alcohol and Drug Rehab Program in New Jersey?
Because every health plan is different, there is not a standard length of coverage for inpatient alcohol and drug rehab. Moreover, every person’s path to recovery looks different, depending upon their own personality, as well as whether they’re struggling with addiction, a mental health disorder, or a co-occurring disorder. It’s important to work with your healthcare provider to determine a course of treatment that will be right for you. While there is no standard length of treatment, research indicates that treatment for substance use disorders should last at least three months in order to be as effective as possible.5
The length of time that your Horizon BCBS insurance will cover any treatment for substance use disorders or co-occurring disorders, including inpatient alcohol and drug rehab, will vary based on the plan type you have, as well as the treatment facility that you select. Be sure to call the number on the back of your insurance card to verify your benefits and coverage, or call the AAC helpline or use the chat option on the AAC website to see if the facility can help you verify your benefits and coverage.
What If My Horizon BCBS Policy Does Not Cover an Inpatient Drug Rehab Program in New Jersey?
Even though the ACA mandates that all health plans provide some level of coverage for treatment programs, including inpatient drug rehab programs, it’s possible that your treatment won’t be fully or partially covered. This may occur if the facility at which you’re receiving care is an out-of-network provider. Or, maybe your plan will only cover a portion of the costs associated with your treatment.
If that’s the case, you may be responsible for paying the costs of treatment out-of-pocket. But there may still be options available to you to help offset the cost of treatment. Be sure to ask your rehab center about special financing options through their facility. You may also qualify for scholarship opportunities, for which you can apply.
Remember, delaying treatment due to finances is not the answer. Getting the help you need now can dramatically improve your life—and it could also help you save money. If you wait to enter treatment, you may have to stay longer to overcome your addiction, which could result in higher rehab costs over time.
Horizon BCBS In-Network vs. Out-of-Network Inpatient Drug Rehab Centers of NJ
Knowing the difference between in-network and out-of-network inpatient drug rehab centers could help you save buckets of money. Typically, in-network providers—those that are part of your insurer’s network of approved providers and facilities—are covered at a higher percentage under your health plan. This means that when you visit these providers or facilities, your out-of-pocket cost will typically be lower than if you were to visit an out-of-network provider (a provider or facility that is not within your insurer’s network of approved providers or facilities). In some cases, out-of-network care may not be covered at all under your plan.
To find out whether a rehab facility is an in-network provider for inpatient drug rehab programs or other types of treatment, you can call the number on the back of your insurance card. Or you can also call the AAC helpline, use the online chat function, or fill out the form at the bottom of this page to see whether the facility you’d like to use is an in-network provider.
How to Find Horizon BCBS-covered Inpatient Drug Treatment Centers in NJ?
Your Horizon BCBS NJ plan likely provides coverage for inpatient drug treatment centers and other types of treatment facilities in New Jersey. To find one near you, try calling the number on the back of your insurance card and logging on to your insurance account online at Horizon BCBS NJ’s website.
You can also call the AAC’s helpline to find a facility near you. Sunrise House, which is an AAC facility in New Jersey, is a leading treatment center in the country. It offers a variety of top-notch, quality rehab programs that can help you overcome your addiction and lead a full, healthy life. For more information about Sunrise House, click here or give us a call today.